Opioids were no more effective at reducing pain for patients with broken limbs than a high-dose combination of the common painkillers ibuprofen and acetaminophen, ingredients in Motrin and Tylenol, in a study published Tuesday by the Journal of the American Medical Association.

The study was conducted by Dr. Andrew Chang of Albany Medical Center, who did the research in the emergency room of Montefiore Medical Center in the Bronx, where he worked until last year. It comes as doctors and public health officials seek alternatives to prescribing opioids, whose overuse and abuse has fueled an alarming rise in overdoses nationwide, with the number of deaths quadrupling since 2000.

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“The study lends evidence that opioids are not always necessary, even in the presence of fractures,” said Chang, a professor of emergency medicine at Albany Med. “Instead of just saying everyone with a fracture needs an opioid, hopefully this will get (prescribers) to start thinking that maybe they don’t.”

Even short-term use of opioid painkillers like hydrocodone and oxycodone can lead todependence, Chang noted. Some four-fifths of people who use heroin, an illegalopioid, started with prescription painkillers, according to federal health officials.

Chang’s study involved 411 emergency room patients aged 21-64 with acute, extreme injuries in an arm or leg that required an x-ray. That was the researchers’ way of determining the intensity of pain would warrant prescribing an opioid.

Patients who consented to participate in the randomized, double-blind study were given either a combination of acetaminophen and ibuprofen or a combination of acetaminophen and one of three opioids — hydrocodone, oxycodone or codeine. Two hours later, researchers assessed them for pain.

The lowest drop in pain scores were reported by patients who received hydrocodone or oxycodone with acetaminophen, but it was not significantly lower than the drop in pain for those who received the non-opioid combination.

The amount of ibuprofen and acetaminophen given was in higher doses than one would normally take at home, consisting of 400 mg of ibuprofen (about twice the usual dose for Motrin) and 1,000 mg of acetaminophen, equivalent to two Extra Strength Tylenol pills.

The study’s results are limited to patients’ pain two hours after medication was given, in an emergency room setting. Researchers also did not consider side effects, which could factor into prescribers’ decisions about what to give for pain. But Chang, who has applied for grants to continue his research, said it is not a big leap to see the study’s implications for prescription decisions made as patients are being discharged home.

He said he hopes the study will begin a conversation about replacing opioids with the two common, non-addictive pain relievers. Many people think of alternating the drugs at home, he said, to manage symptoms like high fevers in children. But Chang referred to the ibuprofen-acetaminophen combo as “peanut butter and jelly” — better together when the aim is pain alleviation.

In New Zealand, he said, a product that combines the medication is available over the counter, he said. He’s not aware that any drug companies are looking to offer such products in the United States but thinks they should. Instead, they are looking for ways to continue to sell opioids in more difficult-to-crush forms that discourage abuse by addicts.

“I think most drug companies are focusing on abuse deterrents, but I would love to see if they would combine the two in a single tablet,” Chang said.